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I am a very friehgtened and shattered man right now. I had unprotected oral sex with a man, who did ejaculate in my mouth exactly fourteen weeks ago. At thirteen weeks and 1 day, I tested negative using Oraquick. I know that this is usually conclusive, but I read all sorts of mixed information everyone on the internet, and get different responses from different people. My problem is this: I take immunosupressive drugs for a kidney transplant. It should be noted that 1) I was on a pretty low dose (200 mg cyclosporin once a day) which I missed quite often (more than half the time) for the first two 1/2 months after the incident. About two weeks before the test, I saw a nephrologist who added Celcept (500 mg x2) and made my Cyclosporing twice a day (still 200 total mg per day). Also, I was taking an antiboitic until a day before I tested. Other information that might be useful:

1) My white count, when I saw my nephrologist, three weeks before testing, was normal2) I had two urine cultures in the days before testing, both were negative for infections, and the urine was clear3) I had pre-op testing for a urethral stricture (a surgery that I've since deemed not neccessary) four days before the test, and was "cleared for surgery," meaning, I assume, that there was no problem white or red count at that point. 4) I had some diahrea and a slight fever about a month before testing (9 1/2 weeks after exposure)

My questions are this:

1) Is it possible to have ARS and still not have seroconverted three weeks after the symptoms dissapear?2) How many cases of "late conversion," after the three month window, are reported each year?3) I have been told various things from HIV hotlines, including 1) the three month window is difinitive for evevyone, 2) no drugs interfere with the testing, with the possible exception of PEP or HAART for post-exposure treatment, and 3) I don't have HIV (GMHC--twice)....can you confirm these things?4) I have been told by an on-line doctor (medhelp) that my chances of having HIV are 1 in 10 million. Does that seem right? 5) I have had a slight white tongue, but it goes away, or at least very much diminishes if I eat yoghurt and drink a lot of water. Does this mean it isn't thrush? 6) Is it possible to reverse seroconvert after you change medications?

It's very unlikely that you were infected through giving a blowjob as this mode of transmission is rare. There have been studies of couples where one partner was positive and one was negative. In these serodiscordant couples who used condoms for anal or vaginal intercourse, but no barrier for any type of oral, not one, NOT ONE of the negative partners became positive. This shows us two things: one, condoms are very effective for the prevention of hiv transmission and two, oral sex is MUCH lower risk than previously believed. So, as I said, it's unlikely this blowjob you gave will result in infection.

There is only the possibility that anti-rejection drugs will delay seroconversion. It's not written in stone.

1. The so called seroconversion illness, or ARS, is what a person MIGHT feel during the process of antibody production so if you did indeed experience ARS, you would have tested positive afterwards.

2. To be honest, I've never seen ANY reported in recent times.

3.1 There is the possibility that some people may seroconvert late and these people are generally on 3.2 chemotherapy for cancer, anti-rejection drugs or have been injecting street drugs every day for years. For people who have been on PEP, the three month window starts when they finish the four week course of PEP drugs. 3.3 I would tend to agree with them, yes, as you didn't have much of a risk to begin with.

4. We don't go by numbers like that here as they are usually pulled out of thin air. We go by the serodiscordant couple studies which I have already discussed with you.

5. We cannot tell you over the internet what is going on with your tongue. Show it to your doctor. Even if it is thrush, please keep in mind that antibiotics can also cause thrush, as can many, many other things aside from hiv.

6. No.

I think it is highly unlikely that you have hiv. If you feel you need to test again for peace of mind, go ahead and test, but expect another negative result.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Ok, now I am really frightened, as this is the first definite link I have heard between anti-rejection medicine and late seroconversion. I just don't understand why this information is so hard to find. There are thousands upon thousands of people living with organ transplants--you would think that some of them would have been tested by now. Is it safe to assume that nearly ALL transplant patients still test positive within the 3 month window? Please, I am dying here. I have been to two hospitals, and no one will give me a prc or nat test, or tell me if my drugs might have altered my negative test.

You've chosen to ignore the most important bit of the information I gave you earlier. Your risk was NEGLIGIBLE. It is RARE for a person, organ transplant recipient or not, to become infected through giving a blowjob.

I do think it is likely that the majority of organ transplant recipients will seroconvert and test positive within the three month window. Especially someone such as yourself who is on a low dose.

It's highly unlikely that your thirteen week negative will change for two reasons. One, you didn't really have a risk of infection in the first place and two, I wouldn't expect you to seroconvert late. You only need further testing if you feel you must for your own peace of mind. I fully expect you to continue testing negative if you do decide to test again. I don't really recommend testing over giving a blowjob in the first place.

Calm down. You're more likely to find a multi-million dollar winning lottery ticket lying in the gutter than you are to test positive over this incident.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

In response to your PM, (and please keep your questions here so others can follow the discussion), I completely agree with Ann.

Your risk was very low to begin with. Your meds in relation to the kidney transplant notwithstanding, when you get a negative at 13 weeks it's money in the bank. The average time to seroconversion is 22 days. All but the very smallest number of those who are going to seroconvert will do so within 4-6 weeks. So even with your specific concern I still would consider that a valid test result.

Sure, go ahead an re-test if you want to for peace of mind. Like Ann I certainly expect you will continue to test negative. It would be beyond rare for you to test positive at this point.

Now I do think you are under a great deal of emotional stress right now. You've indicated you had oral with another guy and it has put your marriage in jeopardy. That's a lot to handle so it's not surprising that you're terrified about HIV right now. I strongly recommend that you see a therapist or other professional to get support dealing with the emotional aspects of this situation.

Even though your wife is apparently very angry right now, a breakup doesn't have to be written in stone. In any case, get yourself some professional support to deal with the situation.

As far as HIV is concerned I expect you to come out of this ok. No kidding.

Thank you both for your responses. What continues to nag me about this event is that I had this wierd illness in Mid-September, that included sore legs, diahrea and a low-grade fever--I thought maybe it was prostitis, because of some pain in my testicles (god, I hope that's not a sign of ARS, too). Like I said, I was on a very low dose of Immunosuppresion for the first 2+ months after the encounter. In fact, when I finally went to see a nephorlogist (3 weeks before the test) she said there was only a "trace" of immunosupprsive drug in my system, so she changed and increased my immunosuppresion. I was also on an antibiotic (for a reason that turned out not to be valid--long story) Once I started the antibiotic, about 8 days before the test (ending one day before the test) I started to feel immediately better--in fact, my kidney function even improved significantly, and I no longer had the shortness of breath (which I had had since before the encoutner, I think, or from right right after) or any other symptoms--is it possible that the antibiotic, or the new drugs reversed the seroconversion while at the same time helping my kidney function improve? It should also be noted that I think I had been retaining a slight bit of water before I got on the antibiotic, and now there is none. I feel much better now than I have in over a year, and my white count is stable, all other labs are stable, no sign of infection in my urine--is any of that encouraging? Does any of it hint that I would not be a late converter? If I had seroconverted early, say even before the wierd illness in early Sept (which I must admit may have been contracted from my daughter, who got ill at daycare) is it possible that the drugs negated the antibodies completely from my blood and made me feel better? Or, if there are antibodies, are they just simply there? I know all of this is extremelly confusing--it's extremely confusing to me, but anything you can do to help me out would be greatly appreciated. I thank you so much for your incredible, compassionate service.

is it possible that the antibiotic, or the new drugs reversed the seroconversion while at the same time helping my kidney function improve?

Flight,

I already answered this in my first reply to you and the answer is NO.

Quote

is it possible that the drugs negated the antibodies completely from my blood and made me feel better?

NO

Quote

Or, if there are antibodies, are they just simply there?

YES!

Here's the clincher:

Quote

she said there was only a "trace" of immunosupprsive drug in my system,

It would take more than a "trace" of the drug to slow your antibody production down to the point where you would take much longer than six weeks to seroconvert. You are hiv negative.

But really, the bottom line here is that you didn't have much of a risk to begin with as getting infected through giving a blowjob is RARE. You repeatedly ignore that point. You didn't actually need to test over this in the first place.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Well, there was a "trace" the day my doctor drew blood (which was 10 weeks post-exposure) but levels in the blood fluctuate as to how well I took my meds. Like I said, I was taking my meds about 1/2-1/3 of the time before the incident, never taking them more than once a day, and usually only taking 100 mg of the cyclosporin rather than the 200 mg prescribed. So, at times, there might have been a lot of immunosupresion in my blood, while at others almost none. Then, two weeks before the test, I took new drugs. It's these new drugs that I worry about--that they someone obliterated the anti-bodies my body had buit up at this point, but you're sure that's COMPLETELY IMPOSSIBLE? I'm checking myself into a psychiatric clinic today, for anxiety and depression and to keep myself from hurting myself over this event, but I may be able to check the site if they have e-mail access there.

I shouldn't have said "at times there would be a lot" of immunusuppresioin in my blood. I'm ten years post-transplant, so the dose (even the new does that I am on) is a maintanence dose, not an intense dose. Does is make any difference that 1) my white count was normal 2 weeks before the test 2) that I had pre-op testing (for an unrelated urehtral stricture that I've had since I was a teenager) four days before the test and I was cleared for surgery, meaning, I assume, that my white count, etc, was still in a decent range or 3) that I had two different urine cultures, both without nitrates in them at all, though one did show a "trace" of wbc.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks for all of your help. One final question. I had my WBC tested three or more times, including during the time when I had diarhea, etc, that i thought might be ars (at 10 weeks) and it was normal every time...and normal 4 days before the test, and normal a week after the test. Does this indicate that 1) I am unlikely to be a late converter, because of normal WBC count and 2) it's unlikely that it was ars, becauase of normal wbc count? I know there's no definitive answer, but I'm asking if this is anohter reason to be hopeful? Thanks so muc for your time.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thanks for your answer, but I am really perplexed--all I did is give a blow job and now I have one pimple and one other microscopic sore on my penis--how would this happen? Is it just something from years ago reapearing?

If you're worried about pimples or any other sores on your penis, you're just going to have to see a doctor about that. We cannot possibly tell you what is going on with your penis over the internet. You can't diagnose yourself either, unless you've suddenly graduated from medical school.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I'm sorry, I really don't mean to be a pest at all, but I'm just hoping that a herpes outbreak is not a sign of hiv. I have been hospitalized for anxiety and depressioin in the last month and I'm sure it's making my responses sound more desperate than they are, but I'm absolutely terrified because of my wife and child (who is breastfeeding). But if you tell me right now, I am in the clear, I will believe you.

I think you are all heroic for providing this service. I am so scared right now--you're assurances have been helpful. I hope that I have not offended you with my posts about Herpes. I just wanted reassurance that this doesn't chance your mind about my chances, that's all. I hope you are all well tonight.

And you as well. Go put on the telly, read a book or otherwise engage your mind and spirit in something more productive than torturing yourself.

Life is way too short to be spending it that way so put some effort into more life-affirming activities. No kidding. You'd be amazed at how it can be done if you're focused that way instead of just giving into your mind's worst fears.

I don't know that I have herpes, but I read on the internet that people with herpes are twice as likely to get hiv. Is this true, even if I only gave oral sex and had no sores at the time? Wouldn't it make sense that I would simply have the same chance as anyone, since I had no sores and my genitals were not involved in the act at all?

Just having herpes does not increase you risk. If, for example, you have a sore on your penis and you have unprotected intercourse with a positive person, then your risk would be slightly higher. People with herpes shouldn't be allowing their herpes lesions to come into contact with another person's body anyway, because that is how herpes is spread.

You really need to relax about this blowjob because it is highly unlikely you have become infected as a result.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Thank you for all your time and consideration. I know you don't answer symptomatic questions on here, but I thought I'd give it a chance. I have a mildly swollen lymph node on the very back of my neck, and it seems to swell up during the night, though during the day I can't even feel it at all. I also have a tingling sensation in the same shoulder, not where the lymph node is but lower. Do lymph nodes normally cause this tingling sensation? The node itself doesn't hurt, and I am hoping the tingling is from stress or from a pinched nerve, but worry that the lymph node is draining during the day and that's what's causing the tingling. If so, would one lymph node warrent more testing, or should I move on?

I know I am being a hypochondriac, but now I have a wierd sort of lesion on my right temple. It sort of looks like a pimple, but is more purplish and smooth. When do hiv lesions usually appear? Does it take years or only weeks? Sorry for the questions, but I can't seem to calm myself down. I am going to take a 4 month test this week.

You only had a theoretical risk to begin with. It's RARE for a person to become infected from giving a blowjob. There is no doubt in my mind that your previous test result is correct. You are hiv negative.

Test again if you like, collect your negative result and move on with your life. But I still say you didn't need to test in the first place.

If you are worried about "lesions" appearing on your skin, you are just going to have to see your doctor about it. There isn't a person in the world who can diagnose these things for you over the internet. Whatever is going on has nothing to do with hiv.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I am terrified now. I was doing so well with my worrying, had put the incident behind me, and decided that my three month test was definitive. Today, though, I have chills and fever, and a temp. around 100.5. Also body aches. Does this information change your opinion about my status or my need for another test? I was really feeling great last night, had taken a deep breath and decided I didn't have it. Now I think I need to go test again. What is your opinion?

I know that you will tell me to speak to a doctor about my symptoms, but I wanted to check with you because every time I think I finally have a handle on things, and can move on, something new crops up and freaks me out. This time, I have a sore on the inside of my lip. I don't know if it's an ulcer or what--it could be from my psych meds that cause dry mouth, or from my kidney meds, which cause many things, but I wanted to check to see if this new symptom changed your opinion about my need for more testing. I really am trying to deal with this, and am seeing a psychologist to help me with the guilt, etc, as you suggested, but I wanted to know if you had any opinion on this new thing that's cropped up. I hope you all are having a wonderful Thanksgiving. I am definately thankful for the support I have gotten from this forum.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I wanted to let you know that I went and got another hiv test on Friday. It was negative again. My wife also tested and also negative. I now believe it is sufficiently long enough for the test to be conclusive. And I should have believed my three month test was conclusive, but I agonized for two months for no reason. It was a form of self-indulgence, I guess, but it also helped me become more aware of hiv and will make me be more careful in the future. In the meantime, I am going to make a donation to an HIV charity (any suggestions?) and move on with my life. Thank you to Andy, Rod and Anne for the work they do.

As to donations, I don't know where you live but any AIDS service organization in your area is sure to need anything you can give. Alternatively GMHC in NY is a major service provider for those living with HIV as well as in prevention.